Donald Trump came within a hair of repealing the Affordable Care Act in 2017. Republicans in Congress and on the courts aren't giving up: Our view

Suppose you have an unhinged neighbor who wants to burn down your house. You’d probably spend much of your time making sure that that doesn’t happen. Drafting plans for a megamansion you hope to build where your house once stood probably wouldn’t be a priority. But that seems to be the approach of some Democratic aspirants for the presidency, who spent big chunks of their recent debates arguing about details of costly "Medicare for All" plans that have no chance of becoming law.

If Trump were to succeed, and because he has no viable plan to replace Obamacare, tens of millions of Americans would lose their coverage, people with preexisting conditions would become vulnerable and an entire industry would be thrown into disarray.

The most expansive Medicare for All plans, offered by Sens. Bernie Sanders and Elizabeth Warren, would remake the American health industry in a way that would do away with private insurance.

Plans such as these are not happening any time soon, even if Democrats manage to win the presidency. They won’t happen for the simple reason that too many Americans have private insurance that they either affirmatively like or would be apprehensive about losing for some uncertain alternative. It's the same dynamic that doomed Bill and Hillary Clinton's health care overhaul a quarter-century ago.

Sens. Bernie Sanders of Vermont and Elizabeth Warren of Massachusetts at the Democratic presidential debate on July 30 in Detroit.(Photo: Justin Sullivan/Getty Images)

Worse yet, the more Democrats talk about expensive and unattainable health care plans, the more they abet Trump’s reelection efforts.

By all counts, the upcoming election should be a referendum on Trump's race-baiting incompetence and malevolence. But if the Democrats field a nominee who wants to nationalize health insurance, Trump’s main talking point — that voters might not like everything he says or does but that his policies are closer to the mainstream than the "socialist" Democrats’ — would be gifted to him.

That's why preserving the ACA has to be the priority. Enacting Obamacare was a big (bleeping) deal, as Vice President Joe Biden put it at the time. The law needs champions who will oppose efforts to repeal it. And it needs fixes that will shore up its shaky markets and exchanges.

If Democrats want to think big, they should focus on adding a public insurance option that would compete alongside private plans. Such an option would increase competition while restraining prices. But even that would be a slog. Democrats couldn't get a public option through the Senate in 2009, when they had a filibuster-proof majority.

It's time for Democrats to get their priorities straight. With great effort and at substantial political cost, they built a better health care structure. Focus on saving it and making some home improvements, not on erecting some future dream home.

USA TODAY's editorial opinions are decided by its Editorial Board, separate from the news staff. Most editorials are coupled with an opposing view — a unique USA TODAY feature.